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Selecting an Anesthesia Provider
Selecting an Anesthesia Provider When patients require surgery, most people trust their surgeon to assure that the individual administering the anesthetic for surgery is competent and qualified. However, this assurance is not automatic, and you, as the patient, have some responsibility in choosing who will provide your anesthetic, just as you do in selecting your surgeon.

When your surgeon schedules your surgery, a specific anesthesia provider might not be requested. Discuss with your surgeon the process for deciding who will administer your anesthetic at the facility where your surgery will be performed. Usually, if a particular provider is not requested, someone in the anesthesia department “assigns” someone to your case.

However, in almost all hospitals, the surgeon, as well as the patient, has the right to request a specific individual.

How do you decide whom to request?
You should be aware that there are two major types of anesthesia providers in the United States. Anesthesiologists are physicians who, in addition to college, have graduated from a four-year medical or osteopathic school, and who have completed a minimum of three or four years in residency in anesthesiology, a medical specialty.

Certified Registered Nurse Anesthetists (CRNAs) are registered nurses who have had nursing experience in a critical care unit (like an ICU), and have then taken an additional 18 to 24 months of training in anesthesia. Although most CRNAs now have a Master’s degree, many practicing CRNAs were trained before it was required, and about a third do not have a bachelor’s degree.

About one third of anesthesiologists work exclusively “one on one,” giving anesthesia directly to patients. For the rest, some or all of their practice is in the “anesthesia care team,” working with CRNAs, and medically directing the care provided by the CRNA. About 80% of CRNAs work in an anesthesia care team. If your surgeon is comfortable with the anesthesiologist who will care for you, then you can probably trust your surgeon’s judgment in selecting the anesthesia provider.

About 20% of CRNAs do not work with an anesthesiologist. It may be a matter of their personal preference, or they may work in a community that does not have an anesthesiologist. In these situations, in most states, the surgeon will be responsible for “supervising” the CRNA, and in a few states, the CRNA will be practicing independently. In either of these situations, you will want to assure that your surgeon will be overseeing the medical aspects of your care while you are receiving anesthesia, because the CRNA, while highly trained in the technical aspects of anesthesia administration, has not attended medical school.

If your surgeon expects the CRNA to provide your medical care, you should see a red flag. When you are having surgery, you want your medical care provided by someone who has attended medical or osteopathic school!

Finally, if you know a particular anesthesiologist personally from a previous anesthetic experience, or have a friend who recommends a particular anesthesiologist, you can contact that anesthesiologist and request that he/she provide your anesthesia care. Sometimes your surgeon can make the arrangement for you.

Your anesthetic care is an important part of your surgical experience. Select your anesthesia provider carefully.

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"Selecting an Anesthesia Provider"
   authored by:
Dr. Glazer is an Indianapolis anesthesiologist who has retired after thirty years of practice. He graduated from the Indiana University School of Medicine in 1971 and subsequently took his internship and anesthesiology residency at the Indiana Unive...

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